A national cross-sectional survey of public perceptions of the COVID-19 pandemic: Self-reported beliefs, knowledge, and behaviors

Abstract

Introduction: Efforts to mitigate the global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing Corona Virus Disease-19 (COVID-19) have largely relied on broad compliance with public health recommendations yet navigating the high volume of evolving information can be challenging. We assessed self-reported public perceptions related to COVID-19 including, beliefs (e.g., severity, concerns, health), knowledge (e.g., transmission, information sources), and behaviors (e.g., physical distancing) to understand perspectives in Canada and to inform future public health initiatives.

Methods: We administered a national online survey aiming to obtain responses from 2000 adults in Canada. Respondent sampling was stratified by age, sex, and region. We used descriptive statistics to summarize responses and tested for regional differences using chi-squared tests, followed by weighted logistic regression.

Results: We collected 1,996 eligible questionnaires between April 26th and May 1st, 2020. One-fifth (20%) of respondents knew someone diagnosed with COVID-19, but few had tested positive themselves (0.6%). Negative impacts of pandemic conditions were evidenced in several areas, including concerns about healthcare (e.g. sufficient equipment, 52%), pandemic stress (45%), and worsening social (49%) and mental/emotional (39%) health. Most respondents (88%) felt they had good to excellent knowledge of virus transmission, and predominantly accessed (74%) and trusted (60%) Canadian news television, newspapers/magazines, or non-government news websites for COVID-19 information. We found high compliance with distancing measures (80% reported self-isolating or always physical distancing). We identified associations between region and self-reported beliefs, knowledge, and behaviors related to COVID-19.

Discussion: We found that information about COVID-19 is largely acquired through domestic news sources, which may explain high self-reported compliance with prevention measures. The results highlight the broader impact of a pandemic on the general public's overall health and wellbeing, outside of personal infection. The study findings should be used to inform public health communications during COVID-19 and future pandemics.

Fig 1. Respondents’ concerns about contracting the virus that causes COVID-19 and the impacts on healthcare.

Fig 2. Difference in five domains of overall health at the start of 2020 compared to the time of questionnaire completion.

Notes: Prefer not to answer responses are excluded from data analyses (range: n = 5, 0.3% to n = 107, 5.4%). Five-point scale ratings were poor, fair, good, very good, and excellent.

Fig 3. Respondents’ understanding of virus transmission and mitigation.

Notes: Prefer not to answer response options are excluded from data analyses (range: n = 15, 0.8% to n = 146, 7.3%). * Percentage for somewhat disagree = 1%; percentage for disagree/strongly disagree = 1%.

Fig 4. Information sources accessed, selected as most trustworthy, least trustworthy, and sources of misinformation indicated by respondents.

Notes: Prefer not to answer responses are excluded from analysis (range: n = 5, 0.3% to n = 99, 5.0%). Canadian news is a combined category of Canadian television news, Canadian newspapers/magazines, and Canadian news websites. American news is a combined category of American television news, American newspapers/magazines, and American news websites. HCPs = healthcare providers; WHO = World Health Organization.

Fig 5. Proportion of respondents who indicated how long they believe they could sustain their current level of physical distancing.

Note: Prefer not to answer response options are excluded from data analyses (n = 12, 0.6%).

Fig 6. Respondents’ motivations for practicing either self-isolation (n = 852) or physical distancing (n = 1,126).

Notes: Prefer not to answer response options are excluded from data analyses (n = 6, 0.7% and n = 4, 0.4%, respectively).